Colorectal Cancer Screening Programme

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Am I suitable to receive CRC screening?

  1. Screening means examining people without symptoms in order to detect disease or identify people at increased risk of disease so that treatment can start earlier to improve the chance of cure. The Colorectal Cancer Screening Programme (“the Programme”) adopts Faecal Occult Blood Test (FOBT) as the main screening test. If FOBT result is positive, the participant will need to receive colonoscopy examination to find out the cause of bleeding. Therefore, the Programme targets at individuals who (1) do not have symptoms and (2) are suitable to receive colonoscopy examination.
  2. It is worthwhile to note that, FOBT, which is similar to other screening tests, has its own limitation and may not be 100% accurate. For example, a person with negative screening test result may indeed have the disease (i.e. false negative result) but he/she will be falsely reassured leading to delay in seeking appropriate medical following up or treatment and hence affecting the prognosis.
  3. Eligible persons who are considering to enroll in the Programme should first understand their own health conditions and relevant medical history because people with the following conditions are not suitable or not necessary to enroll in the Programme.

    4. Condition

    Reason

    Not suitable to enroll in the Programme

    Have symptoms of colorectal cancer

    Individuals with these conditions have higher risk of developing colorectal cancer and are required to receive colonoscopy examination which means to use a flexible scope to inspect the entire colon in order to accurately look for any pathological changes.

    The Programme uses FOBT to detect hidden blood in the colon. Hence if the bleeding does not occur at the time of testing, the abnormalities  may not be detected. This may cause a delay in seeking appropriate medical follow up or treatment and can affect the prognosis.

    Therefore, people with these conditions are not suitable to enroll in the Programme.

    History of colorectal cancer

    History of chronic inflammation of the bowel, e.g. ulcerative colitis

    Diagnosis of hereditary bowel syndromes, or have first-degree relative diagnosed with such syndrome

    History of colorectal polyp

    Previously been advised against receiving colonoscopy by a doctor

    People who are contraindicated to  receive the colonoscopy examination due to various reasons despite a positive FOBT result would make   participation in the Programme become meaningless. It may also potentially create unnecessary anxiety to the participants. Separately, some people may have conditions  wherein treatment cannot improve the quality of life despite a confirmed colorectal cancer diagnosis. This would also make those people not suitable to receive the FOBT. Examples include people with severe heart and lung dysfunction or who are unsuitable to undergo operation.  

    Not necessary to enroll in the Programme

    Record of receiving colonoscopy within the past 10 years with normal result

    Local experts recommend individuals who do not have significant family history can  consider to receive (1) faecal occult blood test every one to two years or (2) sigmoidoscopy every 5 years or (3) colonoscopy every 10 years, for colorectal cancer screening.

    Since the effectiveness of the above three methods are similar, it is not necessary to enroll in the Programme to repeat the screening within the recommended screening interval or with different screening methods.

    Record of receiving flexible sigmoidoscopy within the past 5 years with normal result

    Record of receiving FOBT within the past 2 years with normal result

    Assessment by Primary Care Doctors

  4. The Enrolled Primary Care Doctors will understand the health conditions of the participants and review their relevant medical history to exclude the aforementioned conditions before enrolling the participants into the Programme. It is hoped that eligible persons can understand and co-operate.